Predicting conversion from MCI to AD by integration of rs-fMRI and clinical information using 3D-convolutional neural network

Purpose Alzheimer's is the most common irreversible neurodegenerative disease. Its symptoms range from memory impairments to degradation of multiple cognitive abilities and ultimately death. Mild cognitive impairment (MCI) is the earliest detectable stage that happens between normal aging and early dementia, and even though MCI subjects have a chance of changing back to cognitively normal or even staying the same, there is a risk that their condition progresses to Alzheimer's disease (AD) annually. Therefore predicting AD among MCI subjects is pivotal for starting treatments at an opportune time in case of progression, and if staying stable is the case, the need for consistent medical observations would eliminate. Thus, we aim to diagnose possible conversion from MCI to AD by exploiting a class of deep learning (DL) methods called convolutional neural network (CNN). Methods We proposed a three-dimensional CNN (3D-CNN) to combine and analyze resting-state functional magnetic resonance imaging (rs-fMRI), clinical assessment results, and demographic information to predict conversion from MCI to AD in an average 5-years interval. Initially, a 3D-CNN was developed based on fMRI single volumes of 266 samples from 81 subjects; then, we used neuron layers to combine clinical data with fMRI to improve the results. Results At first, the CNN model demonstrated an AUC of 87.67% and an accuracy of 85.7%, then after combining clinical and rs-fMRI features, we observed the following improved scores: an AUC of 91.72%, an accuracy of 87.6%, a sensitivity of 75.58% and a specificity of 92.57%. Conclusion Our developed algorithm managed to predict prognosis from MCI to AD with high levels of accuracy, proving the potential of DL approaches in solving the matter and the efficiency of integrating clinical information with imaging according to the proposed method.